B-cell Complement Dependent Cytotoxic Crossmatch Positivity is an Independent Risk Factor for Long-term Renal Allograft Survival

• Published in: Journal of Korean medical science Vol. 26; no. 4; pp. 528 - 533
• Main Authors: Hwang, Hyeon Seok, Yoon, Hye Eun, Choi, Bum Soon, Oh, Eun Jee, Kim, Ji Il, Moon, In Sung, Kim, Yong Soo, Yang, Chul Woo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.04.2011; 대한의학회
• Subjects: Acute Disease; Adult; Aged; B-Lymphocytes - immunology; Complement Activation; Cytotoxicity Tests, Immunologic; Female; Graft Survival - immunology; Histocompatibility Testing - methods; Humans; Kidney Transplantation - immunology; Male; Middle Aged; Original; Prognosis; Retrospective Studies; Risk Factors; Survival Analysis; T-Lymphocytes - immunology; Transplantation, Homologous; 의학일반; B-cell; Cytotoxicity Tests, Immunologic; Kidney Transplantation
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2011.26.4.528

The clinical significance of positive B-cell complement-dependent cytotoxicity crossmatching (B-CDC) in renal transplant recipients remains unclear. We reviewed 20 recipients with isolated B-CDC positivity at the time of transplantation. We compared the clinical characteristics, acute rejection and long-term graft survival between positive and negative B-CDC patients (n = 602). The number of retransplant recipients and positivity for T- and B-flowcytometric crossmatch was greater in positive B-CDC patients than in negative B-CDC patients. The overall acute rejection rate of positive B-CDC patients was significantly higher (P < 0.001), and Banff grade II or III cellular rejection was more frequently observed in positive B-CDC patients (P = 0.037). Compared with negative B-CDC patients, acute cellular rejection as a cause of graft loss was more prevalent (P = 0.020) and rescue rejection therapy was more frequently needed in positive B-CDC patients (P = 0.007). The allograft survival rate of positive B-CDC patients was significantly lower than that of negative B-CDC patients (P < 0.001), and B-CDC positivity independently increased the risk of allograft failure 2.31-fold (95% CI 1.15-4.67; P = 0.019) according to multivariate analysis. In conclusion, isolated B-CDC positivity is an independent long-term prognostic factor for allograft survival.